Webinar: Joining nationwide exchange? Be prepared
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NCHICA is a nonprofit consortium of more than 240 organizations dedicated to improving healthcare in North Carolina by accelerating the adoption of IT, Anderson said. As one of its initiatives, the alliance developed a standards-based gateway that enabled the 16-hospital Western North Carolina Health Network (WNCHN) to connect to the NwHIN, eventually connecting the Charles George VA hospital in Asheville as well. The VA is part of the NwHIN, “so data can flow between these [organizations] in an authorized, secure manner,” Anderson said.
He urged potential NwHIN participants to “be aware of the intensity of conformance, interoperability and partner testing that all has to take place before any protected health information is compromised within this connection." Currently, participants must be federal agencies or have a contract with a federal agency that covers NwHIN activities. They also must have governance in place and must have the technical requirements installed. The network's governing body must then approve the entities for interoperability and partner testing.
The process verifies eligibility for participation, compliance with NwHIN specifications and
the organization's ability to exchange information with other parties.
“For those of you out there who may be starting down this path, you need to realize the cost of this is more on the enterprise and community HIE side than it is on the gateway connection to the NwHIN.” Building interfaces and adapters, especially in a federated data model, is crucial, he said. “Different systems and persons have got to be in sync and bringing the MPI [master patient index] across the system may be a challenge. For a single enterprise, it’s much easier to establish as a gateway because they’ve already got the MPI built."
In addition, “sustainability is an issue for all of us as we’re beginning to share information to serve clinical needs. HIE is an expense, so we need to demonstrate the value of this to our community,” said Anderson. “Once we have this instance set up and running, we need more traffic. We need to engage the Social Security Administration, HHS [Department of Health and Human Services], the Department of Defense and the CDC [Centers for Disease Control and Prevention] to run more traffic through this utility,” lowering the cost per transaction.
The Office of the National Coordinator for Health IT is working to streamline the process for NwHIN participation—nevertheless, Anderson advised listeners to “start early: understand the process and the DURSA [Data Use and Reciprocal Support Agreement]. From a policy standpoint, you have to agree before you can participate.”
During the question-and-answer session following his presentation, Anderson was asked why NCHICA decided to connect to the NwHIN. “Why wouldn’t we want to connect?" Anderson said. "The future of healthcare is to bring information to the point of clinical decision-making. We know it’s across enterprises, it’s across state boundaries and we know a lot of this information resides in federal agencies. So to serve the population, we have to connect. The NwHIN gives us the opportunity to gain insight into those standards and policies that will be required for cross-enterprise/region/nation exchange. It’s allowed us to educate ourselves to be prepared, to be at the forefront of service for patients.”
The webinar was presented by the National eHealth Collaorative.